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Gestational diabetes: Glycaemic predictors for fetal macrosomia and maternal risk of future diabetes
Linköping University, Department of Medical and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology. Linköping University, Faculty of Medicine and Health Sciences.
Umeå University, Sweden.
Uppsala University, Sweden.
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2016 (English)In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 114, 99-105 p.Article in journal (Refereed) PublishedText
Abstract [en]

Aims: To investigate how glucose levels at diagnosis of gestational diabetes (GDM) are associated with infant birth weight and long-term risk of manifest diabetes mellitus in the mother. Methods: In a case control study GDM pregnancies (n = 2085) were compared with non-GDM pregnancies matched for day of delivery and obstetric unit (n = 3792). GDM was defined as capillary blood glucose (cB-glucose) >9.0 mmol/l (plasma glucose >10.0 mmol/l) after a 75 g oral glucose tolerance test (OGTT). The GDM cohort were followed up 8.5-13.5 yrs after initial diagnosis with a questionnaire, answered by 1324 GDM women (65%). Results: GDM women had higher mean infant birth-weight compared with controls (3682 g vs. 3541 g, P < 0.001). In multiple linear regression analysis, birth weight was positively correlated to fasting cB-glucose at GDM diagnosis (P < 0.001), increased week of gestation (P < 0.001) and BMI before pregnancy (P < 0.003), while 2 h OGTT cB-glucose values >= 9.0 mmol/l were not related. Infants born to mothers with fasting cB-glucose >= 4.5 mmol/l had no increased mean birth-weight or macrosomia (>= 4500 g) compared to controls. In the follow up 334/1324 women (25%) of the GDM women had developed diabetes, 215 type 2 diabetes, 46 type 1 diabetes and 72 unclassified diabetes. In logistic regression fasting cB-glucose and 2 h OGTT cB-glucose at diagnosis of GDM as well as BMI >25 and origin outside Europe were risk factors for manifest diabetes. Conclusions: Fasting blood glucose at diagnosis of GDM gives important information besides 2 h OGTT glucose about pregnancy outcome and future risk for maternal diabetes. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD , 2016. Vol. 114, 99-105 p.
Keyword [en]
Birth weight; Pregnancy; GDM; Blood glucose; OGTT
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-128751DOI: 10.1016/j.diabres.2015.12.017ISI: 000375129600015PubMedID: 26818892OAI: oai:DiVA.org:liu-128751DiVA: diva2:931940
Note

Funding Agencies|Swedish Diabetes Association; Medical Research Council of Southeast Sweden (FORSS); Linkoping University, Sweden

Available from: 2016-05-31 Created: 2016-05-30 Last updated: 2016-05-31

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Wahlberg Topp, JeanetteEkman, BertilArnqvist, Hans
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Department of Medical and Health SciencesDepartment of EndocrinologyFaculty of Medicine and Health SciencesDivision of Cell Biology
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